Pancho - LEI-EMI-99

Code: LEI-EMI-99
Mercy ID: V-02721-12
Encounter Date: 02/27/2008
Last: Leimbach
First: Emily
DOB: 11/08/1999
County: Dekalb
Street: 2670 Rangewood Dr.
City: Atlanta
State: GA

Zip

30345-

Home

(770) 493-9459

Cell

(404) 431-7586

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Shelter

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Linda Leimbach	N/A	USA
Father	James Leimbach	N/A	USA
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Immaculate Heart of Mary
Grade: 2nd.
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo